COVID-19 has spawned this new SDOH
This week, a federal court judge in Florida ruled that the CDC overstepped its authority by mandating mask wearing on public transportation.
Never mind that the CDC’s mandate is in response to the deadliest pandemic in modern times. Never mind that COVID-19 continues to spawn new variants. Never mind that those variants are spreading freely. Never mind that masks are effective protection from getting a virus.
This single court ruling (apparently based on a lack of understanding of the word “sanitation” in the context of public health policy) wiped out one of the few remaining public health practices that protects people from getting infected.
A failure of government
This ruling is the latest in a series of failures by our government to promote and protect people’s health in response to COVID-19.
Two years in, our government has failed at getting people to understand and accept the seriousness of the pandemic. It’s failed at getting all of us (or at least a majority) to take precautions consistently. And now one branch of government is actively undermining the authority of another.
This judge’s ruling doesn’t provide checks and balances. It politicizes public health and safety. One legal expert characterized the ruling in this way: “It reads like someone who had decided the case and then tried to dress it up as legal reasoning without actually doing the legal reasoning.”
All these failures add to the public health chaos we continue to experience. Our government failed to effectively counter misinformation and confusion spread by others. With this latest action our own government is directly contributing to that confusion.
After the ruling was announced, airlines immediately dropped their masking requirements. Videos appeared on social media showing people mid-flight taking off their masks and waving them about like little flags. Pilots made gleeful announcements over their PA systems. One airline declared their relief that “COVID-19 has transitioned to an ordinary seasonal virus.” Only to backtrack a few hours later after public health leaders publicly disputed the airline’s claim.
While many people greet this ruling with glee, many others feel only trepidation. People who remain vulnerable to the worst COVID outcomes just saw one of the few remaining legal protections to preserve their health disappear.
At this point, I expect people who are anti-mask, anti-vax, anti-any-restrictions will continue to act aggressively toward anyone wearing a mask in public. Bullying people wearing masks or trying to take other precautions. I don’t expect us to live and let live.
Governmental philosophy as a social determinant of health
What this has shown me is that our government’s political philosophy, on which it decides its role to play in public health, has a direct impact on our health risks and outcomes. In the past we’ve thought about the results of actions by government in public health as being part of the social determinants of health (SDOH). This includes things like building water treatment plants or hospitals.
But when a government no longer feels that it has a role to play in preserving and protecting the public’s health, that also has a direct impact on health risks and outcomes. We need to start looking not just at what a government does, but also the assumptions it brings to its public health decision making process. Ultimately, the government’s political philosophy will drive how and whether a government will protect its public’s health — or not.
What’s ahead for public health in the US? it remains to be seen. But the Justice Department is appealing the ruling that put an end to the CDC’s mask mandate on public transportation.